| NPI | 1700071255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA 4452) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD T6330) |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2011-12-21 |