| NPI | 1912463431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA02375500) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 044012) |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2025-11-11 |