| NPI | 1194887091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0000969) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT0009272L) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2007-07-08 |