| NPI | 1215103080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: AZ 8041) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 8041) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2017-07-27 |