| NPI | 1164050233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA00624200) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NJ 41YS00928700) |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2020-04-01 |