| NPI | 1245283456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 254) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 904-024) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2007-07-08 |