| NPI | 1801379995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 043553) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01796400) |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2018-09-13 |