| NPI | 1720290976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV 446) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 4086) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2010-03-10 |