| NPI | 1013364629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 5312) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 040085) |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2016-05-24 |