| NPI | 1679116768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA02054900) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 044292) |
| 261QP2000X Clinic/Center, Physical Therapy (Licence: NJ 40QA2054900) | |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2022-07-22 |