| NPI | 1205103090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT022603) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 034214-1) |
| Enumeration Date | 2011-11-21 |
| Last Update Date | 2019-10-25 |