| NPI | 1710472576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305214805) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA0176500) |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2022-08-12 |