| NPI | 1609614627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA02033400) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT029901) |
| Enumeration Date | 2024-07-15 |
| Last Update Date | 2024-07-16 |