| NPI | 1154504579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 23006) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 0282291) |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2022-07-21 |