| NPI | 1417395153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 17568) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 12673) |
| 225100000X Physical Therapist (Licence: VI 162) | |
| 225100000X Physical Therapist (Licence: AK 1740) | |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2013-06-04 |