| NPI | 1578867453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 18934) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT38610) |
| 225100000X Physical Therapist (Licence: CT 10521) | |
| 225100000X Physical Therapist (Licence: MI 5501302038) | |
| Enumeration Date | 2011-01-06 |
| Last Update Date | 2022-05-18 |