| NPI | 1063656528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: 37423) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: NY 022278-1) |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2021-10-27 |