| NPI | 1710199104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 012670-1) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 15211) |
| Enumeration Date | 2007-05-06 |
| Last Update Date | 2007-07-09 |