| NPI | 1861953606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 040748-1) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT032383) |
| 225100000X Physical Therapist (Licence: MA PTL28026) | |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2025-03-31 |