| NPI | 1174306880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT41251) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 050963) |
| Enumeration Date | 2023-08-16 |
| Last Update Date | 2024-04-08 |