| NPI | 1518396910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OR 60405) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 036350) |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2013-11-06 |