| NPI | 1689230963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 049699) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 012027) |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2022-11-16 |