| NPI | 1629790456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT031762) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 043761) |
| Enumeration Date | 2022-09-19 |
| Last Update Date | 2024-03-04 |