| NPI | 1700303971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL.0016256) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 042047-1) |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2019-07-31 |