| NPI | 1437455193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 032628-1) |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy (Licence: GA PT013666) |
| Enumeration Date | 2011-01-28 |
| Last Update Date | 2019-10-31 |