| NPI | 1467463083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 03212) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070.013367) |
| 225100000X Physical Therapist (Licence: MO 112711) | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2007-07-08 |