| NPI | 1629589411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01759300) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 042158) |
| Enumeration Date | 2017-10-19 |
| Last Update Date | 2017-10-19 |