| NPI | 1255644852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J10002940) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01359700) |
| Enumeration Date | 2010-07-23 |
| Last Update Date | 2013-03-25 |