| NPI | 1972672632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 031643-1) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 21199) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2010-03-08 |