| NPI | 1003163346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 13735) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 7640) |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2016-05-12 |