| NPI | 1700492725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT42590) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 046300) |
| Enumeration Date | 2020-09-16 |
| Last Update Date | 2026-02-06 |