| NPI | 1942082516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC 210002402) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA0002060900) |
| Enumeration Date | 2023-10-18 |
| Last Update Date | 2024-01-05 |