| NPI | 1821611633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 037925) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01905900) |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2021-04-12 |