| NPI | 1619210408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT PTP-PT-LIC-14175) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P12851) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2018-05-03 |