| NPI | 1104960343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 012008-1) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2025-01-23 |