| NPI | 1053953554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 13692) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 041578) |
| Enumeration Date | 2019-10-16 |
| Last Update Date | 2021-09-24 |