| NPI | 1831564640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: NY 039623) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: NY 039623) |
| Enumeration Date | 2015-12-04 |
| Last Update Date | 2023-03-14 |