| NPI | 1194242776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01757300) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 13233) |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2022-07-05 |