| NPI | 1104229756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY P94772) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: NY P94772) |
| Enumeration Date | 2014-09-26 |
| Last Update Date | 2016-08-03 |