| NPI | 1508107699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT 21850) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 036128) |
| 225100000X Physical Therapist (Licence: NY 036128-01) | |
| Enumeration Date | 2013-03-14 |
| Last Update Date | 2023-03-08 |