| NPI | 1649994542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305215430) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 046410) |
| Enumeration Date | 2022-10-04 |
| Last Update Date | 2022-10-04 |