| NPI | 1558599522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 1814) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KS 11-01557) |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2009-06-29 |