| NPI | 1164734257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 018352-1) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT012088L) |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2022-07-14 |