| NPI | 1902532278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 009632) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 020863) |
| Enumeration Date | 2022-07-28 |
| Last Update Date | 2022-07-28 |