| NPI | 1962896407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01946400) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NJ 40QB00302300) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2020-11-30 |