| NPI | 1174647069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070.012672) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: IL 070012672) |
| Enumeration Date | 2007-03-18 |
| Last Update Date | 2011-07-11 |