| NPI | 1821212523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT001019E) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA00281300) |
| 225100000X Physical Therapist (Licence: VA 2305002112) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2007-07-08 |