| NPI | 1720536592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT023381) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P17015) |
| 225100000X Physical Therapist (Licence: NJ 40QA01552300) | |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2021-08-20 |