| NPI | 1215468574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 011834) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 8664) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2023-09-21 |