| NPI | 1598415325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT030318) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA02071800) |
| Enumeration Date | 2022-03-25 |
| Last Update Date | 2023-08-15 |