| NPI | 1710219464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ PTQA00645500) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 014301-1) |
| Enumeration Date | 2010-02-05 |
| Last Update Date | 2015-12-04 |