| NPI | 1548635576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 039612) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 011320) |
| Enumeration Date | 2015-12-02 |
| Last Update Date | 2019-08-08 |