| NPI | 1083080394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 041720-1) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 21922) |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2021-03-01 |