| NPI | 1689790313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 126421) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 0170151) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2010-01-26 |