| NPI | 1689452906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 050220) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: NY 050220) |
| Enumeration Date | 2023-09-18 |
| Last Update Date | 2024-08-14 |