| NPI | 1811516339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: PA PT028188) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: NJ 40QA01917700) |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2025-05-29 |