| NPI | 1104291160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 10748) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 039567) |
| Enumeration Date | 2015-12-02 |
| Last Update Date | 2015-12-02 |