| NPI | 1639493414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NH 2060) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 6299) |
| Enumeration Date | 2010-03-23 |
| Last Update Date | 2010-03-23 |