| NPI | 1366998429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1288760) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01684800) |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2022-07-21 |