| NPI | 1285067504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P14397) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 8978) |
| Enumeration Date | 2013-08-11 |
| Last Update Date | 2018-06-24 |