| NPI | 1003947482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 2295) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NH CP000110T) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2019-07-31 |