| NPI | 1942400122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 4989) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01247400) |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2007-12-11 |