| NPI | 1609244847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT30728) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ QA00492900) |
| Enumeration Date | 2015-09-04 |
| Last Update Date | 2015-09-04 |