| NPI | 1760790711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P12858) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 033009) |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2010-09-23 |