| NPI | 1073160107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 740216) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 008680) |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2019-08-22 |