| NPI | 1164195954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305214526) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 043943) |
| Enumeration Date | 2021-07-27 |
| Last Update Date | 2021-09-07 |