| NPI | 1972149276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305213165) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01781100) |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2019-11-21 |