| NPI | 1578915757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 039149) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0013898) |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2016-07-12 |