| NPI | 1275163693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 045110-01) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 24729) |
| Enumeration Date | 2020-01-24 |
| Last Update Date | 2025-08-28 |