| NPI | 1609465095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 054332) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 0017467) |
| Enumeration Date | 2021-01-11 |
| Last Update Date | 2026-03-23 |