| NPI | 1972713824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT21576) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 9914) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2007-07-08 |