| NPI | 1063885259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AR PT4458) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 30429) |
| Enumeration Date | 2015-11-10 |
| Last Update Date | 2019-09-13 |