| NPI | 1356775209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305208585) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01503600) |
| Enumeration Date | 2013-08-28 |
| Last Update Date | 2020-10-22 |