| NPI | 1649724949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VT 0400132485) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 11086) |
| Enumeration Date | 2016-08-04 |
| Last Update Date | 2018-05-21 |