| NPI | 1124611611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 37862) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 046550-01) |
| Enumeration Date | 2021-02-16 |
| Last Update Date | 2022-10-18 |