| NPI | 1043853872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 13289) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 045031) |
| Enumeration Date | 2019-10-24 |
| Last Update Date | 2021-01-18 |