| NPI | 1609171487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305205837) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 11273-024) |
| 225100000X Physical Therapist (Licence: MN 7982) | |
| 225100000X Physical Therapist (Licence: WA 60097488) | |
| Enumeration Date | 2011-01-25 |
| Last Update Date | 2011-01-25 |