| NPI | 1255484580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ PT10084) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 23143) |
| 225100000X Physical Therapist (Licence: AL PTH6021) | |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2014-04-09 |