| NPI | 1538694633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305210215) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA PT60713930) |
| 225100000X Physical Therapist (Licence: TX 1275916) | |
| 225100000X Physical Therapist (Licence: AZ 12506) | |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2017-04-26 |