| NPI | 1215519988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 045887) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT032266) |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2024-06-27 |