| NPI | 1659058121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT39813) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA02146600) |
| Enumeration Date | 2023-06-28 |
| Last Update Date | 2024-02-22 |