| NPI | 1972823284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT008653) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 9538) |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2010-06-09 |