| NPI | 1073033080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 046953) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01962100) |
| 2251X0800X Physical Therapist, Orthopedic | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NY 003478) | |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NJ 25MT00278900) | |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2022-11-18 |