| NPI | 1558802066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NV 3253) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 22066) |
| 225100000X Physical Therapist (Licence: CA 291472) | |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2020-03-04 |