| NPI | 1497623979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT40550) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY PT051274) |
| Enumeration Date | 2025-10-27 |
| Last Update Date | 2025-10-27 |