| NPI | 1356423412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 6100) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT21156) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2008-02-11 |