| NPI | 1619130796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA00259800) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 11594) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2021-01-28 |