| NPI | 1750457875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305213987) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 021873-1) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2024-08-27 |