| NPI | 1619271087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305209511) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 032800) |
| Enumeration Date | 2010-12-28 |
| Last Update Date | 2016-03-03 |