| NPI | 1316346760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 040.0124176) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01214100) |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2019-12-19 |