| NPI | 1710864541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD CP048903T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA02208200) |
| Enumeration Date | 2025-08-21 |
| Last Update Date | 2025-08-29 |