| NPI | 1508010786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 22612) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 028736) |
| 225100000X Physical Therapist | |
| Enumeration Date | 2008-11-13 |
| Last Update Date | 2016-10-27 |