| NPI | 1154571958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT6379) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MT 1594) |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2018-10-05 |