| NPI | 1053868067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 039919) |
| Additional Taxonomies | 174400000X Specialist |
| 225200000X Physical Therapy Assistant (Licence: NY 009436) | |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2024-07-16 |