| NPI | 1164764734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 036952) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT020325) |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2014-03-11 |