| NPI | 1275068066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1289433) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01723000) |
| Enumeration Date | 2017-04-29 |
| Last Update Date | 2017-04-29 |