| NPI | 1720058399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA00932600) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 20801) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2007-07-08 |