| NPI | 1598091498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO CO4074) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM NM3725) |
| Enumeration Date | 2009-10-27 |
| Last Update Date | 2009-10-27 |