| NPI | 1780346064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 12827) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA02056300) |
| Enumeration Date | 2021-10-13 |
| Last Update Date | 2025-11-25 |