| NPI | 1962004713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT37941) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 045141) |
| Enumeration Date | 2020-11-16 |
| Last Update Date | 2023-02-07 |