| NPI | 1184909558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P10359) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: NC P10359) |
| Enumeration Date | 2011-10-18 |
| Last Update Date | 2021-09-21 |