| NPI | 1073767091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 28726) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 030002-1) |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2014-08-14 |