| NPI | 1467658336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 5011) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: CT 005011) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2013-02-15 |