| NPI | 1265945778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MO 2018028631) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: MO 2017038181) |
| Enumeration Date | 2017-11-07 |
| Last Update Date | 2020-02-10 |