| NPI | 1649433269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-3958) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL-10035) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2021-08-18 |