| NPI | 1891934568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 028660-1) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NY 001227-1) |
| Enumeration Date | 2009-02-19 |
| Last Update Date | 2022-02-17 |