| NPI | 1760689939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 21384) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01100300) |
| 225100000X Physical Therapist (Licence: OH 0116611) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2018-12-19 |