| NPI | 1649789322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305214206) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 042113-1) |
| Enumeration Date | 2017-09-25 |
| Last Update Date | 2022-01-20 |