| NPI | 1063873289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-32828) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: AZ LPT-32828) |
| 225100000X Physical Therapist (Licence: NY 040027-1) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: NY 040027-1) | |
| Enumeration Date | 2016-03-15 |
| Last Update Date | 2025-05-07 |