| NPI | 1689032955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 039459) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305210000) |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2020-08-03 |