| NPI | 1205460490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 11725) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA02022100) |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2021-09-16 |