| NPI | 1497779664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 21850) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 17564) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2011-02-09 |