| NPI | 1669722369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 035641-1) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01464200) |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2013-09-05 |