| NPI | 1366790412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 035398) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 62 035398) |
| Enumeration Date | 2012-08-21 |
| Last Update Date | 2022-07-21 |