| NPI | 1649507344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 12114) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT000344E) |
| Enumeration Date | 2009-11-17 |
| Last Update Date | 2009-11-17 |