| NPI | 1578932455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID 4149) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AK 104731) |
| 225100000X Physical Therapist (Licence: NY 039488) | |
| Enumeration Date | 2015-09-21 |
| Last Update Date | 2020-10-08 |