| NPI | 1275531675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 11156) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 009744-1) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2022-06-27 |