| NPI | 1770004756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT41414) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 041190) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2024-03-05 |