| NPI | 1215130422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT025238) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01246000) |
| 225100000X Physical Therapist (Licence: MI 5501015607) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2017-02-15 |