| NPI | 1164147088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 047256) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225100000X Physical Therapist (Licence: 047256) | |
| Enumeration Date | 2022-10-04 |
| Last Update Date | 2022-10-04 |