| NPI | 1669674669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT 1809) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 02195) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2007-07-08 |