| NPI | 1578853875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 36368) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ PT40QA01092900) |
| 225100000X Physical Therapist (Licence: PA PT016462) | |
| Enumeration Date | 2011-04-08 |
| Last Update Date | 2011-04-08 |