| NPI | 1669551024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 006488) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 4130) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2020-10-06 |