| NPI | 1366083503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01892600) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: NJ 40QA01892600) |
| 2251S0007X Physical Therapist, Sports (Licence: NJ 40QA01892600) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: NJ 40QA01892600) | |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2023-07-17 |