| NPI | 1639174089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT016487) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01111500) |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2014-01-17 |