| NPI | 1639453269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ QAO1408200) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 26772) |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2015-05-19 |