| NPI | 1710466776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA1896700) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 23699) |
| Enumeration Date | 2018-08-10 |
| Last Update Date | 2020-10-14 |