| NPI | 1275708513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 2212-024) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 5575) |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2008-04-28 |