| NPI | 1659648376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT030127) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01427000) |
| Enumeration Date | 2011-11-23 |
| Last Update Date | 2022-12-05 |