| NPI | 1124544879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 8737) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT30170) |
| 225100000X Physical Therapist (Licence: ID 3860) | |
| 225100000X Physical Therapist (Licence: NM 5007) | |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2017-08-15 |