| NPI | 1770861213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305208291) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 033837-1) |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2021-08-23 |