| NPI | 1811213986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT020467) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01219700) |
| Enumeration Date | 2010-04-14 |
| Last Update Date | 2010-04-14 |