| NPI | 1477853323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305206821) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 032120) |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2013-05-15 |