| NPI | 1104456227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 022012) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 044713) |
| Enumeration Date | 2020-01-16 |
| Last Update Date | 2020-01-16 |