| NPI | 1689972697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA 021129) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WV 002919) |
| Enumeration Date | 2011-03-01 |
| Last Update Date | 2011-04-12 |