| NPI | 1205474335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 043428) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 63207) |
| 225100000X Physical Therapist (Licence: NM PT5363) | |
| 225100000X Physical Therapist (Licence: MA 23944) | |
| Enumeration Date | 2019-12-19 |
| Last Update Date | 2019-12-19 |