| NPI | 1063795227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 6192) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 26317) |
| 225100000X Physical Therapist (Licence: NC 9893) | |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2011-09-23 |