| NPI | 1811159106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: GA PT009614) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 24102) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2009-06-09 |