| NPI | 1629283601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH 9718) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 10373) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2007-07-08 |