| NPI | 1821753385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT41821) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 047981) |
| Enumeration Date | 2021-11-01 |
| Last Update Date | 2024-08-12 |