| NPI | 1801679733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 053268) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 27056) |
| Enumeration Date | 2023-08-15 |
| Last Update Date | 2024-11-06 |