| NPI | 1629655261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 0432531) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 043253-1) |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2021-04-19 |