| NPI | 1720793870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT028907) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01979000) |
| Enumeration Date | 2023-01-23 |
| Last Update Date | 2023-01-23 |