| NPI | 1104369883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 040940) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NC 006285) |
| Enumeration Date | 2016-11-29 |
| Last Update Date | 2018-08-27 |