| NPI | 1962090878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: 046370) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 146370) |
| Enumeration Date | 2021-01-06 |
| Last Update Date | 2021-01-13 |