| NPI | 1457619462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 13599) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 6475) |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2012-04-26 |