| NPI | 1720123474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 322507) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 003715) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2007-07-08 |