| NPI | 1164575718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 14782) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DC PT471) |
| 225100000X Physical Therapist (Licence: NY 022465-1) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2008-01-18 |