| NPI | 1942501481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01633100) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 032801) |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2021-12-08 |