| NPI | 1720157415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111NR0400X (Licence: AZ 6019) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner (Licence: AZ 2315) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2007-07-09 |