| NPI | 1073095550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PR 4556) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT33972) |
| Enumeration Date | 2018-08-31 |
| Last Update Date | 2020-06-15 |