| NPI | 1649969544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 051081-01) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 013302-01) |
| Enumeration Date | 2023-05-05 |
| Last Update Date | 2023-11-15 |