| NPI | 1770642654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 016652) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1216047) |
| 225100000X Physical Therapist (Licence: CA 23317) | |
| 225100000X Physical Therapist (Licence: NJ 40QA00722000) | |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2022-04-12 |