| NPI | 1699949511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: WI 225100000) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 1712-024) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2008-04-22 |