| NPI | 1861694283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305202546) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 020678) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2019-09-19 |