| NPI | 1972995553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 040204-1) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225100000X Physical Therapist (Licence: NY 040204) | |
| Enumeration Date | 2015-02-19 |
| Last Update Date | 2019-06-14 |