| NPI | 1689880114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT21968) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ QA001090900) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2007-07-08 |