| NPI | 1235263237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT005556L) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA00329200) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2007-07-08 |