| NPI | 1861612459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CT 002864) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 011759-1) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2022-05-19 |