| NPI | 1053832733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01256000) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 035014) |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2017-07-14 |