| NPI | 1508593641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 050790-01) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 012051-01) |
| Enumeration Date | 2022-08-08 |
| Last Update Date | 2023-09-14 |