| NPI | 1912543984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 045009-01) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 012275) |
| 225100000X Physical Therapist (Licence: UT 11166298-2401) | |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2019-11-25 |