| NPI | 1972114700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01941800) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT031115) |
| Enumeration Date | 2020-08-14 |
| Last Update Date | 2023-06-06 |