| NPI | 1558600403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 036929) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 12285-24) |
| 225100000X Physical Therapist (Licence: CT 9615) | |
| Enumeration Date | 2013-02-12 |
| Last Update Date | 2014-07-23 |