| NPI | 1629092507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 4OQA01257800) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 019293-1) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2008-02-11 |