| NPI | 1073038345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 041928) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 010815) |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2022-07-21 |