| NPI | 1639569783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40 QA00590100) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT21501) |
| Enumeration Date | 2015-01-28 |
| Last Update Date | 2015-01-28 |