| NPI | 1508265281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 4682) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA00892600) |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2019-01-04 |