| NPI | 1104945369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P16288) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 21884) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2019-08-26 |