| NPI | 1134154180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 018453-1) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VT 040-0003543) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2012-08-27 |