| NPI | 1568615920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01421900) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DE J1-0002387) |
| 225100000X Physical Therapist (Licence: PA PT019624) | |
| Enumeration Date | 2008-10-29 |
| Last Update Date | 2017-08-09 |