| NPI | 1619297439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 19580) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 19580) |
| 225100000X Physical Therapist (Licence: CA 291310) | |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2020-10-20 |