| NPI | 1609840818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 4019) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 2282) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2007-07-08 |