| NPI | 1205232121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 6681) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 7327) |
| Enumeration Date | 2014-11-05 |
| Last Update Date | 2014-11-05 |