| NPI | 1952322562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT025242) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501017751) |
| 225100000X Physical Therapist (Licence: NJ QA01029800) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2022-01-17 |