| NPI | 1679823843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA 21522) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 12858) |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2015-09-17 |