| NPI | 1679034557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 4161) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics |
| 2251N0400X Physical Therapist, Neurology | |
| 2251P0200X Physical Therapist, Pediatrics | |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2019-03-25 |