| NPI | 1063177947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 052151-01) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT37979) |
| 225100000X Physical Therapist (Licence: NJ 40QA02215600) | |
| Enumeration Date | 2021-11-04 |
| Last Update Date | 2025-10-22 |