| NPI | 1619461043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 042752) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MA 23537) |
| 225100000X Physical Therapist (Licence: MA 438159) | |
| 225100000X Physical Therapist (Licence: CA 295218) | |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2019-12-06 |