| NPI | 1659629558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01549800) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 20224) |
| Enumeration Date | 2012-08-27 |
| Last Update Date | 2014-12-04 |