| NPI | 1124834296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA CP049270T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA02308000) |
| Enumeration Date | 2024-12-04 |
| Last Update Date | 2025-09-15 |