| NPI | 1760760615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT021400) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 033612) |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2011-07-26 |