| NPI | 1578901716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 18900) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1228953) |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2013-06-10 |