| NPI | 1073058566 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1347172) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01668100) | 
| 225100000X Physical Therapist | |
| Enumeration Date | 2016-12-20 | 
| Last Update Date | 2024-04-09 |