| NPI | 1295114817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ND 2000) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: NE 3449) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2016-06-15 |