| NPI | 1619353117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NJ 40QA01780000) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 21941) |
| Enumeration Date | 2015-08-06 |
| Last Update Date | 2018-03-26 |