| NPI | 1679197909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 034019) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ME PT5265) |
| 225100000X Physical Therapist | |
| Enumeration Date | 2020-06-02 |
| Last Update Date | 2021-04-26 |