| NPI | 1245608835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 25695) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT024560) |
| Enumeration Date | 2015-09-13 |
| Last Update Date | 2019-10-18 |