| NPI | 1922772870 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 047321)  | 
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 012029)  | 
| Enumeration Date | 2021-08-04 | 
| Last Update Date | 2021-08-04 |