| NPI | 1235666991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01725700) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1284199) |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2017-05-12 |