| NPI | 1639514623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1228979) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01299300) |
| Enumeration Date | 2013-05-03 |
| Last Update Date | 2013-05-03 |