| NPI | 1255056479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NY 013411) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 041537) |
| Enumeration Date | 2022-10-10 |
| Last Update Date | 2022-10-10 |