| NPI | 1962877829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 039753-1) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 039753-1) |
| Enumeration Date | 2015-12-03 |
| Last Update Date | 2024-01-19 |