| NPI | 1538529219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305211554) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT 43570) |
| Enumeration Date | 2016-02-24 |
| Last Update Date | 2019-01-25 |