| NPI | 1902133226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT22614) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA00466600) |
| Enumeration Date | 2009-11-06 |
| Last Update Date | 2010-06-28 |