| NPI | 1497039770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 032745-1) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501014872) |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2012-04-29 |