| NPI | 1457508129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 15644) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 23397) |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2008-08-25 |