| NPI | 1275785222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 17100) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT60041775) |
| 225100000X Physical Therapist (Licence: NY 62 026805) | |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2008-10-21 |