| NPI | 1790152387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01826100) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 25630) |
| Enumeration Date | 2015-08-31 |
| Last Update Date | 2018-11-06 |