| NPI | 1114701778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 051169) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: NY 051169-01) |
| Enumeration Date | 2023-08-23 |
| Last Update Date | 2023-10-25 |