| NPI | 1699124891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 13178-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 22026) |
| 225100000X Physical Therapist (Licence: SC 8051) | |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2019-03-27 |