| NPI | 1821698507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT030029) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 046510) |
| Enumeration Date | 2020-10-30 |
| Last Update Date | 2023-02-06 |