| NPI | 1336501626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 027958) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 027958-1) |
| 208100000X Physical Medicine & Rehabilitation (Licence: NJ 40QA01347000) | |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2016-07-01 |