| NPI | 1710119748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: HI PT-3894) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 0312051) |
| Enumeration Date | 2009-08-08 |
| Last Update Date | 2022-08-16 |