| NPI | 1700199619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CT 8851) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 28939) |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2024-09-17 |