| NPI | 1699952408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT008191L) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA00684800) |
| Enumeration Date | 2008-01-23 |
| Last Update Date | 2018-03-23 |