| NPI | 1699034272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 040519) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PR 1434) |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2022-07-21 |