| NPI | 1184976987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 23566) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01463900) |
| Enumeration Date | 2012-10-04 |
| Last Update Date | 2018-07-30 |