| NPI | 1710199005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ QA00428500) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 12928) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2023-03-31 |