| NPI | 1104282466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT028993) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 22087) |
| 225100000X Physical Therapist (Licence: NJ 40QA01985000) | |
| Enumeration Date | 2016-01-01 |
| Last Update Date | 2020-12-22 |