| NPI | 1194735654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT 23898) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 018765-1) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2008-06-20 |