| NPI | 1861985707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: HI 4633) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 042962-1) |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2020-12-01 |