| NPI | 1740403963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA 006994) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 0212471) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-01-11 |