| NPI | 1942897905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT40027) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 046399) |
| Enumeration Date | 2020-12-24 |
| Last Update Date | 2023-03-10 |