| NPI | 1801364740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA01808000) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DC PT5000001) |
| Enumeration Date | 2018-11-08 |
| Last Update Date | 2021-07-14 |