| NPI | 1164011300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01924100) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT028877) |
| Enumeration Date | 2021-01-12 |
| Last Update Date | 2021-04-15 |