| NPI | 1245261916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 0214641) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: 0214641) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2017-06-23 |