| NPI | 1124779137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 048223) |
| Additional Taxonomies | 2081P0010X Physical Medicine & Rehabilitation Pediatric Rehabilitation Medicine (Licence: NY 048223) |
| Enumeration Date | 2022-01-11 |
| Last Update Date | 2024-04-10 |