| NPI | 1609409465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT031138) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 145636-01) |
| Enumeration Date | 2020-02-19 |
| Last Update Date | 2023-08-15 |