| NPI | 1407095870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 24333) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 16745) |
| Enumeration Date | 2009-02-09 |
| Last Update Date | 2009-02-09 |