| NPI | 1285203885 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 047319) |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy (Licence: NY 047319) |
| Enumeration Date | 2021-06-18 |
| Last Update Date | 2022-11-29 |