| NPI | 1497082689 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT020268)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 62 031963)  | 
| Enumeration Date | 2009-11-09 | 
| Last Update Date | 2009-11-09 |