| NPI | 1356964175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 013631-01) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT002995E) |
| 225100000X Physical Therapist (Licence: NJ 40QA00673000) | |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2021-04-09 |