| NPI | 1114541158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 044113-1) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 012148) |
| Enumeration Date | 2020-06-05 |
| Last Update Date | 2021-04-08 |