| NPI | 1134415904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 082111) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT021265) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2019-01-25 |