| NPI | 1720359540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2011031150) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT010826) |
| Enumeration Date | 2012-01-25 |
| Last Update Date | 2012-12-03 |