| NPI | 1700883766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 841) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 01481) |
| Enumeration Date | 2005-07-06 |
| Last Update Date | 2008-10-22 |