| NPI | 1366956146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NH 4308) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 011039) |
| Enumeration Date | 2017-12-01 |
| Last Update Date | 2018-01-22 |