| NPI | 1588148712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 09599R) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic (Licence: LA 09599R) |
| Enumeration Date | 2018-09-24 |
| Last Update Date | 2018-09-24 |