| NPI | 1730065079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA02357100) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA CP048691T) |
| Enumeration Date | 2025-08-13 |
| Last Update Date | 2025-08-13 |