| NPI | 1316393903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 009925) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 036665) |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2016-05-12 |