| NPI | 1902922461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA00213000) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 040-0003715) |
| 225100000X Physical Therapist (Licence: MA 17838) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2007-07-08 |