| NPI | 1639809056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA02099200) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-8180) |
| Enumeration Date | 2022-06-16 |
| Last Update Date | 2022-07-10 |