| NPI | 1679014906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P16619) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 22192) |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2017-03-20 |