| NPI | 1710566682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NM PT5929) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 046706) |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2021-08-26 |