| NPI | 1013253780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT011257) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01471200) |
| Enumeration Date | 2012-12-27 |
| Last Update Date | 2021-11-24 |