| NPI | 1710265947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01781000) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 033890) |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2021-04-23 |