| NPI | 1053524074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 7055) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 5177) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2007-07-08 |