| NPI | 1003206426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 037094) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: HI PT-4056) |
| Enumeration Date | 2015-01-24 |
| Last Update Date | 2016-05-03 |