| NPI | 1639910672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 309875) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA02256100) |
| Enumeration Date | 2024-06-04 |
| Last Update Date | 2026-04-02 |