| NPI | 1902179682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305213316) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01411400) |
| Enumeration Date | 2012-02-11 |
| Last Update Date | 2020-02-18 |