| NPI | 1164634564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 2762) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA 00487R) |
| 225100000X Physical Therapist (Licence: VA 2305003284) | |
| 225100000X Physical Therapist (Licence: OH 003436) | |
| 225100000X Physical Therapist (Licence: HI 2144) | |
| 225100000X Physical Therapist (Licence: FL 3733) | |
| Enumeration Date | 2007-05-06 |
| Last Update Date | 2007-07-08 |