| NPI | 1245923432 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA02219900) | 
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: PA TE013371) | 
| Enumeration Date | 2023-06-01 | 
| Last Update Date | 2023-12-13 |