| NPI | 1871940874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 040132) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01709300) |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2019-02-05 |