| NPI | 1306988464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 1960) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 2831) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2017-12-01 |