| NPI | 1609331909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 046995) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 011773) |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2021-03-18 |