| NPI | 1770817736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 5212PT) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WY PT-0897) |
| Enumeration Date | 2009-09-23 |
| Last Update Date | 2009-09-23 |