| NPI | 1609196153 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070.015151)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 25158)  | 
| Enumeration Date | 2010-06-07 | 
| Last Update Date | 2010-06-07 |