| NPI | 1154788040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 3414) |
| Additional Taxonomies | 174400000X Specialist (Licence: SC 3414) |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2020-10-27 |