| NPI | 1689028615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA 004899) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: SC 2677) |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2016-04-15 |