| NPI | 1376394049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC PT210002323) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA02025200) |
| Enumeration Date | 2024-03-29 |
| Last Update Date | 2024-03-29 |