| NPI | 1235841511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT031306) |
| 225100000X Physical Therapist (Licence: NY 049864) | |
| Enumeration Date | 2022-12-19 |
| Last Update Date | 2024-07-19 |