| NPI | 1881769644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 11931) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT22318) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2009-02-24 |