| NPI | 1609065499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070.012067) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 03131) |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2007-10-17 |