| NPI | 1205034451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 62026413) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 25437) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2016-07-20 |