| NPI | 1124782495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 055456) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 013166) |
| Enumeration Date | 2021-10-23 |
| Last Update Date | 2025-12-01 |