| NPI | 1508988783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 15434) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 33021) |
| 225100000X Physical Therapist (Licence: NY 021888-1) | |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2007-07-08 |