| NPI | 1053366864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT013185L) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA00755600) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2016-06-14 |