| NPI | 1154629749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO PTL-10552) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P13503) |
| Enumeration Date | 2011-03-05 |
| Last Update Date | 2012-02-01 |