| NPI | 1740332246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 5307) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MN 6614) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2007-07-09 |