| NPI | 1982939021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 040.0111025) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01332800) |
| Enumeration Date | 2009-10-07 |
| Last Update Date | 2015-12-22 |