| NPI | 1417209453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05009816A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 9034) |
| 225100000X Physical Therapist (Licence: FL PT 23592) | |
| 225100000X Physical Therapist (Licence: OH PT 010595) | |
| Enumeration Date | 2012-10-15 |
| Last Update Date | 2012-10-15 |