| NPI | 1396813309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-629) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: ID PT-629) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2024-08-01 |