| NPI | 1295113462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 10730) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225200000X Physical Therapy Assistant (Licence: CT 1548) | |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2018-10-25 |