| NPI | 1841569381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC PT5000012) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 030508) |
| Enumeration Date | 2011-12-28 |
| Last Update Date | 2022-03-21 |