| NPI | 1154867042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 114355) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070.010801) |
| Enumeration Date | 2017-01-16 |
| Last Update Date | 2017-01-16 |