| NPI | 1659619690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 040.0134720) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT017667) |
| 225100000X Physical Therapist (Licence: NJ 40QA01350400) | |
| Enumeration Date | 2013-01-25 |
| Last Update Date | 2024-10-15 |