| NPI | 1669895306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 009992) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT010040L) |
| 225100000X Physical Therapist (Licence: NY 037346-1) | |
| Enumeration Date | 2014-01-31 |
| Last Update Date | 2019-09-05 |