| NPI | 1639579600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 0363321) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 10058) |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2014-08-27 |