| NPI | 1962747980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01475500) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 30373) |
| Enumeration Date | 2012-12-03 |
| Last Update Date | 2019-02-11 |