| NPI | 1417520925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0019610) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA02014100) |
| Enumeration Date | 2021-07-21 |
| Last Update Date | 2025-05-22 |