| NPI | 1215493630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 10165) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 043973) |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2022-02-28 |