| NPI | 1912080607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2007012833) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05008292A) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2013-01-08 |