| NPI | 1659104743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA CP049271T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA02277800) |
| Enumeration Date | 2024-08-23 |
| Last Update Date | 2025-09-08 |