| NPI | 1306439617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 39506) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01993100) |
| Enumeration Date | 2021-02-17 |
| Last Update Date | 2022-12-20 |