| NPI | 1043976830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 048262) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 013075) |
| Enumeration Date | 2021-11-16 |
| Last Update Date | 2022-03-07 |