| NPI | 1487727558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AR PT 2975) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: AR PTA 2008) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2007-07-27 |