| NPI | 1902200090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT023931) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01577200) |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2023-08-25 |