| NPI | 1104989805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 021953) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 0219531) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2008-12-16 |