| NPI | 1619040763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 0000005747) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AL PTH5946) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2022-10-26 |