| NPI | 1104004050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 017477) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 007635) |
| Enumeration Date | 2008-02-02 |
| Last Update Date | 2021-06-16 |