| NPI | 1619459609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 10053) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 040303) |
| Enumeration Date | 2018-09-05 |
| Last Update Date | 2018-09-05 |