| NPI | 1861910028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 044679-01) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225200000X Physical Therapy Assistant (Licence: NY 011079) | |
| Enumeration Date | 2017-09-07 |
| Last Update Date | 2023-07-02 |