| NPI | 1154923860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 046972) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01967800) |
| Enumeration Date | 2020-11-09 |
| Last Update Date | 2023-04-12 |