| NPI | 1699669507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA CP044990T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA02340400) |
| Enumeration Date | 2025-06-05 |
| Last Update Date | 2025-06-05 |