| NPI | 1669906780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01787400) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1239581) |
| Enumeration Date | 2017-04-14 |
| Last Update Date | 2021-01-19 |