| NPI | 1063496172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH 10960) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 10960) |
| 225100000X Physical Therapist (Licence: NY 10960) | |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2007-07-08 |