| NPI | 1164854832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305209254) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01500200) |
| Enumeration Date | 2013-08-05 |
| Last Update Date | 2015-04-10 |