| NPI | 1952417974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 9579) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TN 7591) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2008-02-28 |