| NPI | 1235491853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC PT871765) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT010630) |
| 225100000X Physical Therapist (Licence: SC 4157) | |
| 225100000X Physical Therapist (Licence: NJ 40QA01341500) | |
| Enumeration Date | 2012-06-10 |
| Last Update Date | 2015-01-26 |