| NPI | 1558597468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 6660) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 12155) |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2015-01-14 |