| NPI | 1972626323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 024887-1) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1-8654-4) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2007-07-08 |