| NPI | 1508038761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 11403) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AR 3167) |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2011-10-04 |