| NPI | 1093220931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PT5745) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MS PT5745) |
| Enumeration Date | 2017-12-13 |
| Last Update Date | 2017-12-13 |