| NPI | 1164401717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 3276) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ AZ3276) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2011-06-23 |