| NPI | 1396086765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 021890-1) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 009435) |
| Enumeration Date | 2013-03-11 |
| Last Update Date | 2021-05-21 |