| NPI | 1174121115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT030451) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 046424) |
| Enumeration Date | 2020-10-13 |
| Last Update Date | 2023-02-21 |