| NPI | 1972136448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT014509) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01898200) |
| Enumeration Date | 2020-02-12 |
| Last Update Date | 2020-03-25 |