| NPI | 1134342751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 12585-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 029293) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2019-10-23 |