| NPI | 1528540432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 13459) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 043295) |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2026-08-20 |