| NPI | 1144317991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD 18934) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-02-04 |