| NPI | 1578894374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 06784) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: LA Z11182) |
| Enumeration Date | 2010-01-19 |
| Last Update Date | 2011-07-19 |