| NPI | 1487166278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 019658-1) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 019183) |
| Enumeration Date | 2017-11-01 |
| Last Update Date | 2023-08-22 |