| NPI | 1700335593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 041489) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 11157) |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2020-12-10 |