| NPI | 1962753244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305207599) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 034885-1) |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2012-09-26 |