| NPI | 1780127043 |
|---|---|
| Former Name | ALEXIS DICKOVER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 11764) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01668000) |
| Enumeration Date | 2016-11-18 |
| Last Update Date | 2022-06-03 |