| NPI | 1265799811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC PT871151) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 041277) |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2022-07-21 |