| NPI | 1104711951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA00538500) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: NJ 40QA00538500) |
| 2251G0304X Physical Therapist, Geriatrics (Licence: NJ 40QA00538500) | |
| Enumeration Date | 2025-06-11 |
| Last Update Date | 2025-06-11 |