| NPI | 1255777959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305207903) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 035537) |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2013-05-21 |