| NPI | 1700216702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 044959-01) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305208335) |
| Enumeration Date | 2013-11-13 |
| Last Update Date | 2019-12-06 |