| NPI | 1669532966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 06666) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: LA Z12219) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2007-07-08 |