| NPI | 1962028761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 044765) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 044765-01) |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2023-10-02 |