| NPI | 1134678865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 040.0101826) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM PT5162) |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2018-03-02 |