| NPI | 1689878217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P11324) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA0118500) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2016-03-07 |