| NPI | 1043565831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: HI 2255) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 5183) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2012-07-17 |