| NPI | 1356011803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT029869) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA02046300) |
| Enumeration Date | 2021-09-16 |
| Last Update Date | 2023-05-12 |