| NPI | 1831555820 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 8007)  | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 039704)  | 
| Enumeration Date | 2016-01-07 | 
| Last Update Date | 2016-01-07 |