| NPI | 1558842104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NH CP000165T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM PT5350) |
| 225100000X Physical Therapist | |
| 225100000X Physical Therapist (Licence: TX 1274666) | |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2019-05-24 |