| NPI | 1649575184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225000000X Orthotic Fitter |
| 225700000X Massage Therapist | |
| 225X00000X Occupational Therapist | |
| 225XH1200X Occupational Therapist, Hand | |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2011-01-13 |