| NPI | 1780360594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 053178) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA02175400) |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2024-10-01 |