| NPI | 1760859904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0018924) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 039055) |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2023-05-25 |