| NPI | 1083164131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 11078) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 62 040590) |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2022-01-19 |