| NPI | 1316124514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WY 1296) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 33053) |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2014-06-12 |