| NPI | 1720081144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PR 1195) |
| Additional Taxonomies | 174400000X Specialist (Licence: PR 1195) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2014-11-07 |