| NPI | 1043091911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 051423-01) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 012128-01) |
| Enumeration Date | 2023-10-09 |
| Last Update Date | 2024-01-28 |