| NPI | 1568745909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY 006417) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 62012593) |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2022-01-11 |