| NPI | 1316222060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: SC 7258) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 7258) |
| 225100000X Physical Therapist (Licence: NJ 40QA0893200) | |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2022-11-22 |