| NPI | 1780989160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OK PT4330) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 27762) |
| Enumeration Date | 2011-01-17 |
| Last Update Date | 2012-12-03 |