| NPI | 1023197373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 18078) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 21867) |
| 225100000X Physical Therapist (Licence: PA PT019257) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2018-08-27 |