| NPI | 1659449551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 11530) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 5689) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2012-11-16 |