| NPI | 1588094734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY NY016488) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305208432) |
| Enumeration Date | 2013-11-25 |
| Last Update Date | 2021-07-15 |