| NPI | 1194363788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 045301) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2019-12-14 |
| Last Update Date | 2020-07-08 |