| NPI | 1225144876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: AZ 6015) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: CO 3435) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2007-12-14 |