| NPI | 1376963090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 23895) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1232547) |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2018-09-12 |