| NPI | 1629635768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305212311) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 043286) |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2019-05-23 |