| NPI | 1255927091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305216840) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 046643) |
| Enumeration Date | 2020-12-16 |
| Last Update Date | 2024-11-25 |