| NPI | 1255856597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-013472) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01741500) |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2021-03-14 |