| NPI | 1083264758 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 14827)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 044682)  | 
| Enumeration Date | 2019-09-16 | 
| Last Update Date | 2025-10-17 |