| NPI | 1134471899 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 035066-1)  | 
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: NJ 40QA01699600)  | 
| Enumeration Date | 2012-10-04 | 
| Last Update Date | 2016-10-27 |