| NPI | 1174540728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 4122) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 4972) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2008-04-25 |