| NPI | 1114012515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2004027809) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner (Licence: MO 2001013160) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2022-05-09 |