| NPI | 1790102846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 036017) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT023356) |
| 225100000X Physical Therapist (Licence: NC P14619) | |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2014-03-26 |