| NPI | 1437496122 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 026833)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 39044)  | 
| Enumeration Date | 2013-01-15 | 
| Last Update Date | 2013-01-15 |