| NPI | 1497773832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 10337-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305006561) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2007-07-08 |