| NPI | 1609043983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT015319) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01057100) |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2008-05-15 |