| NPI | 1508595505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: NY 013265) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 048590) |
| Enumeration Date | 2022-06-07 |
| Last Update Date | 2022-06-07 |