| NPI | 1902504558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 14481) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 051112) |
| 225200000X Physical Therapy Assistant (Licence: NY 012097) | |
| Enumeration Date | 2023-02-22 |
| Last Update Date | 2024-07-23 |