| NPI | 1366087165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 297537) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 46TR01091200) |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2023-01-04 |