| NPI | 1508966177 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 010846)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01639500)  | 
| Enumeration Date | 2006-09-24 | 
| Last Update Date | 2017-05-12 |