| NPI | 1124502919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 043012) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 007382) |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2023-08-24 |