| NPI | 1457696221 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 62031917)  | 
| Additional Taxonomies | 2251N0400X Physical Therapist, Neurology (Licence: NY 41353)  | 
| 2251N0400X Physical Therapist, Neurology (Licence: UT 8820640-2401)  | |
| Enumeration Date | 2012-12-05 | 
| Last Update Date | 2016-01-21 |