| NPI | 1699063214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 24034) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT021319) |
| Enumeration Date | 2011-07-17 |
| Last Update Date | 2014-10-24 |