| NPI | 1467544783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT019576) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01213400) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2018-07-06 |