| NPI | 1043702913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 045624-01) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 010740-1) |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2020-05-26 |