| NPI | 1417926494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305204784) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01158400) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2011-08-05 |