| NPI | 1639554702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 032472) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01607200) |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2015-07-29 |