| NPI | 1619046216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 10159) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 02264) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2007-07-08 |