| NPI | 1972774271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2006013159) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070.015740) |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2008-03-14 |