| NPI | 1679286322 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 13911)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 049900)  | 
| Enumeration Date | 2022-12-27 | 
| Last Update Date | 2023-05-10 |