| NPI | 1083013908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 12528) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01560100) |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2022-08-11 |