| NPI | 1164168613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 050560-01) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA02085900) |
| Enumeration Date | 2022-05-09 |
| Last Update Date | 2023-08-24 |