| NPI | 1942207311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT14801) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT60282951) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2013-01-28 |