| NPI | 1609070044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NV 2402) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2001011178) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2011-06-06 |