| NPI | 1124675517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 045862) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 011632) |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2020-08-31 |