| NPI | 1609475730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 14161) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 042405) |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2025-07-28 |