| NPI | 1710422985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 040394) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 040394-1) |
| Enumeration Date | 2016-12-27 |
| Last Update Date | 2021-07-01 |