| NPI | 1760425813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SD 1111) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 03616) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2007-07-08 |