| NPI | 1407117708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: HI 4340) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 033155-1) |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2020-07-24 |