| NPI | 1255958377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01958700) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 045839-01) |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2021-08-09 |