| NPI | 1477572105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 19497) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT018656) |
| 225100000X Physical Therapist (Licence: NY 025882-1) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2012-04-19 |