| NPI | 1457506685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT005349L) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA00511900) |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2008-12-02 |