| NPI | 1699184861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 23426) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1248080) |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2020-08-20 |