| NPI | 1245563196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172M00000X Mechanotherapist (Licence: WI 3790-046) |
| Additional Taxonomies | 305S00000X Point of Service (Licence: WI 3790-046) |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2009-09-10 |