| NPI | 1184347767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT43005) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 049316) |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2022-09-20 |
| Last Update Date | 2025-04-30 |