| NPI | 1225220569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 5586) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01148100) |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2012-11-01 |