| NPI | 1669055398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01999300) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 40QA01999300) |
| 225100000X Physical Therapist (Licence: MI 5501302049) | |
| Enumeration Date | 2021-04-30 |
| Last Update Date | 2022-05-31 |