| NPI | 1174195663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P20410) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 053821) |
| 225100000X Physical Therapist (Licence: NJ 40QA02315800) | |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2026-01-05 |