| NPI | 1609072420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01562300) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 026464) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2015-06-15 |