| NPI | 1356819049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 045074) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT026566) |
| Enumeration Date | 2018-11-12 |
| Last Update Date | 2023-07-30 |