| NPI | 1275294266 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 048323)  | 
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 030670)  | 
| Enumeration Date | 2022-01-03 | 
| Last Update Date | 2022-02-06 |