| NPI | 1356675268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 25198) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 031815) |
| Enumeration Date | 2009-09-24 |
| Last Update Date | 2020-03-06 |