| NPI | 1063133809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 29304) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 049176-01) |
| Enumeration Date | 2022-09-09 |
| Last Update Date | 2025-07-14 |