| NPI | 1053768721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01654900) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT025095) |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2023-03-27 |