| NPI | 1689692113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 5189) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 003335) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2007-07-10 |