| NPI | 1043299407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT026721) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM 3150) |
| 225100000X Physical Therapist (Licence: NV 2188) | |
| 225100000X Physical Therapist (Licence: KS 11-04734) | |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2021-12-29 |