| NPI | 1003104654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P15498) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 034017) |
| Enumeration Date | 2011-07-18 |
| Last Update Date | 2015-04-21 |