| NPI | 1356731707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1260323) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01589500) |
| Enumeration Date | 2015-01-23 |
| Last Update Date | 2019-02-18 |