| NPI | 1740865500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 038789-01) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 086271) |
| Enumeration Date | 2021-03-13 |
| Last Update Date | 2021-03-13 |