| NPI | 1619376092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE 0002571) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 004774) |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2019-06-11 |