| NPI | 1902124969 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05010205A) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070.017738) | 
| 225100000X Physical Therapist (Licence: MI 5501014932) | |
| Enumeration Date | 2010-05-13 | 
| Last Update Date | 2010-10-11 |