| NPI | 1609134220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01216200) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 62022587) |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2012-05-02 |