| NPI | 1770001893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01980300) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 0096201) |
| Enumeration Date | 2017-09-08 |
| Last Update Date | 2022-08-29 |