| NPI | 1588057210 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 62-037262)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 3722621)  | 
| Enumeration Date | 2015-03-05 | 
| Last Update Date | 2024-11-19 |