| NPI | 1205485737 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 28504) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01885300) |
| Enumeration Date | 2019-09-07 |
| Last Update Date | 2023-03-20 |