| NPI | 1790361103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 047042) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NV 4826) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2024-01-29 |