| NPI | 1962968826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1102721) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01170300) |
| Enumeration Date | 2019-02-15 |
| Last Update Date | 2025-10-29 |