| NPI | 1215193131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT 2263) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: MT 2263) |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2014-12-03 |