| NPI | 1407364359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 8959) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC PT.8959) |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2020-10-27 |