| NPI | 1427662394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 045979) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NJ 045979) |
| Enumeration Date | 2020-09-08 |
| Last Update Date | 2022-03-21 |