| NPI | 1225781263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 38256) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 047725-01) |
| Enumeration Date | 2022-01-31 |
| Last Update Date | 2023-03-10 |