| NPI | 1285647560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 003469) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 019380-1) |
| 225100000X Physical Therapist (Licence: MA AH 5584-PT) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2007-07-08 |