| NPI | 1417615972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305215419) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 048285) |
| Enumeration Date | 2021-12-02 |
| Last Update Date | 2023-01-25 |