| NPI | 1619988557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 10600-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 21137) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2007-07-08 |