| NPI | 1013390103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 078076) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070020025) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2020-05-18 |