| NPI | 1689978736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01639900) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305206770) |
| Enumeration Date | 2011-01-04 |
| Last Update Date | 2015-12-01 |