| NPI | 1336357300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 104258) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 3866024) |
| 225100000X Physical Therapist (Licence: NE 3340) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2014-08-03 |