| NPI | 1417227372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305209119) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 034614-1) |
| Enumeration Date | 2012-01-10 |
| Last Update Date | 2019-05-31 |