| NPI | 1982250502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA02230400) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 042079-1) |
| Enumeration Date | 2019-08-11 |
| Last Update Date | 2024-08-14 |