| NPI | 1396833802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 1217) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT002430) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2007-07-08 |