| NPI | 1720507148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT-103241) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 042120-1) |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2025-01-22 |