| NPI | 1083243257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 047390) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA 24776) |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2021-09-14 |