| NPI | 1215576293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 044865) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 040.0134120) |
| 225100000X Physical Therapist (Licence: LA 10470R) | |
| Enumeration Date | 2019-12-23 |
| Last Update Date | 2021-07-12 |