| NPI | 1811265804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-05499) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01427600) |
| Enumeration Date | 2011-12-06 |
| Last Update Date | 2020-01-13 |