| NPI | 1639407117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA DAPT004313) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT013722L) |
| 225100000X Physical Therapist (Licence: NJ 40QA01560000) | |
| Enumeration Date | 2009-11-22 |
| Last Update Date | 2021-03-04 |