| NPI | 1104830769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT018472) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 0185481) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2007-07-08 |