| NPI | 1891845244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 006091-1) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: NY 006091-1) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2007-07-08 |