| NPI | 1164511663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD PT #16204) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MD PT16205) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2023-12-27 |