| NPI | 1649397878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT018530) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 17819) |
| 225100000X Physical Therapist (Licence: MO 2005020337) | |
| 225100000X Physical Therapist (Licence: WA PT00010020) | |
| 225100000X Physical Therapist (Licence: TX 1150252) | |
| 225100000X Physical Therapist (Licence: HI PT2719) | |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2007-07-08 |