| NPI | 1609131630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 39024) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 31327) |
| 225100000X Physical Therapist (Licence: TX 1206461) | |
| 225100000X Physical Therapist (Licence: OR 06765) | |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2018-11-28 |