| NPI | 1629282058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA PTL.0015178) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 016208) |
| 225100000X Physical Therapist (Licence: NJ 40QA01000900) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2019-08-23 |