| NPI | 1518302751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 25809) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT022348) |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2022-03-03 |