| NPI | 1609959642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01124300) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 025621) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2019-11-16 |