| NPI | 1598171621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IA 077496) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NE 3339) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2015-08-04 |