| NPI | 1245649268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2014027151) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2020-08-12 |