| NPI | 1679801682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 031046-1) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 26162) |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2011-01-20 |