| NPI | 1619270162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 032966) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 00517) |
| Enumeration Date | 2010-12-06 |
| Last Update Date | 2010-12-06 |