| NPI | 1265918205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 005150) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 013017-1) |
| Enumeration Date | 2018-07-12 |
| Last Update Date | 2018-07-12 |