| NPI | 1114304359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 035095) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1223018) |
| 225100000X Physical Therapist (Licence: NJ 40qa01968900) | |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2021-05-03 |