| NPI | 1215703400 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 05035601)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P22663)  | 
| 225100000X Physical Therapist (Licence: CT 14463)  | |
| Enumeration Date | 2023-11-29 | 
| Last Update Date | 2025-02-26 |