| NPI | 1740613546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 036416) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 036416) |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2015-02-27 |