| NPI | 1912205956 |
|---|---|
| Former Name | LUDIVINA SALON DAOMILAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 030632-1) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 030632) |
| Enumeration Date | 2011-02-28 |
| Last Update Date | 2015-06-10 |