| NPI | 1053696849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NV 00922) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 00580) |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2011-10-12 |