| NPI | 1497590368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA CP032446T) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: NJ 40QA02260000) |
| Enumeration Date | 2024-07-01 |
| Last Update Date | 2024-07-16 |