| NPI | 1164640603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J2-0000098) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: DE J2-0000098) |
| Enumeration Date | 2007-04-22 |
| Last Update Date | 2021-05-10 |