| NPI | 1629376249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SD 1888) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NE 3046) |
| Enumeration Date | 2011-03-06 |
| Last Update Date | 2016-08-22 |