| NPI | 1356698849 |
|---|---|
| Former Name | RENATA PAC |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01456200) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 048742) |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2022-07-20 |