| NPI | 1760603112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01313700) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 016585-1) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2010-08-18 |