| NPI | 1679824122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 008922-1) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 004893) |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2012-09-24 |