| NPI | 1083773477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT022712) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 01717) |
| 225100000X Physical Therapist (Licence: KS 11-01468) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2015-01-11 |