| NPI | 1164954087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC 872079) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 26359) |
| 225100000X Physical Therapist (Licence: NY 036512) | |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2017-03-30 |