| NPI | 1972361376 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 41353)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 051069)  | 
| Enumeration Date | 2024-03-11 | 
| Last Update Date | 2024-03-11 |