| NPI | 1427483189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0003036) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0012345) |
| Enumeration Date | 2013-09-12 |
| Last Update Date | 2014-01-07 |