| NPI | 1063071298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01831200) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 053638) |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2025-03-06 |