| NPI | 1710396833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT29884) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: NY 036955) |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2015-01-29 |