| NPI | 1306308192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01856800) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT027643) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2019-05-21 |