NPI | 1558752600 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: NY 62035207) |
Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: CO PTL.0012581) |
363AM0700X Physician Assistant, Medical (Licence: NY 35207) | |
Enumeration Date | 2015-02-11 |
Last Update Date | 2023-07-17 |