| NPI | 1407107253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01489600) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 034463-1) |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2020-11-18 |