| NPI | 1265603617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 23256) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AL PTH5530) |
| 225100000X Physical Therapist (Licence: CA 33845) | |
| 225100000X Physical Therapist (Licence: AL PTH7148) | |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2016-08-10 |