| NPI | 1083811970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P13607) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 5696) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2012-07-04 |