| NPI | 1457849192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305006539) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA00597200) |
| Enumeration Date | 2018-04-27 |
| Last Update Date | 2018-04-27 |