| NPI | 1902349103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT023489) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01519300) |
| 225100000X Physical Therapist (Licence: NY 040869-1) | |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2016-11-21 |