| NPI | 1063971695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 11961) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 041921) |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2024-01-12 |