| NPI | 1265689723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PT021955) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT24229) |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2012-06-13 |