| NPI | 1275663411 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT35667) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 4OQAO1131300) | 
| Enumeration Date | 2007-03-06 | 
| Last Update Date | 2021-03-22 |