| NPI | 1679022123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AK 108403) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 61478) |
| 225100000X Physical Therapist (Licence: AZ 11011) | |
| 225100000X Physical Therapist (Licence: NY 037144) | |
| 225100000X Physical Therapist (Licence: CO PTL.0014076) | |
| 225100000X Physical Therapist (Licence: CA 41872) | |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2018-02-23 |