| NPI | 1922354273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: PA DAPT003258) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01442600) |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2016-12-15 |