| NPI | 1902123847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 031008) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MT 2481) |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2011-10-17 |