| NPI | 1710066238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 002597) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 3727) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2007-07-08 |