| NPI | 1649563305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 034163) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 19488) |
| 225100000X Physical Therapist (Licence: CO PTL-11087) | |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2011-09-23 |