| NPI | 1205007580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2006009286) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT018439) |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2008-03-14 |