| NPI | 1700190824 |
|---|---|
| Former Name | SARA MARIE DEROSA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: CO 0012844) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 8976) |
| Enumeration Date | 2010-07-30 |
| Last Update Date | 2023-05-31 |