| NPI | 1578845707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NE 2914) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 004628) |
| Enumeration Date | 2011-09-14 |
| Last Update Date | 2020-11-23 |