| NPI | 1760564603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 2913) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PR 322) |
| 225100000X Physical Therapist (Licence: GA 006153) | |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2007-07-09 |