| NPI | 1104371079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305213110) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 62 040456) |
| 2251P0200X Physical Therapist Pediatrics (Licence: VA 2305213110) | |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2023-10-02 |