| NPI | 1629466925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 62 037742) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 21500) |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2015-01-08 |