| NPI | 1164541819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 2076) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 7606) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2011-01-24 |