| NPI | 1568862316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 011190-1) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 0111901) |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2019-12-23 |