| NPI | 1639899537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA02087600) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 048863) |
| Enumeration Date | 2022-08-31 |
| Last Update Date | 2025-11-25 |