| NPI | 1104526078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 050160) |
| 225100000X Physical Therapist (Licence: VA 2305215604) | |
| Enumeration Date | 2023-03-08 |
| Last Update Date | 2024-04-17 |