| NPI | 1073801171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL0014909) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 19571) |
| 225100000X Physical Therapist (Licence: NY 034133) | |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2019-11-26 |