| NPI | 1184166092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 055654) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: DE J2-0001084) |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2026-03-05 |