| NPI | 1629300876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 028188-1) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 008394) |
| 225100000X Physical Therapist (Licence: OH 012682) | |
| 225100000X Physical Therapist (Licence: AZ 3288) | |
| Enumeration Date | 2010-02-12 |
| Last Update Date | 2010-02-12 |