| NPI | 1861767394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 9832) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 20947) |
| Enumeration Date | 2012-03-16 |
| Last Update Date | 2012-03-16 |