| NPI | 1710222302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 8004) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P15719) |
| Enumeration Date | 2012-12-07 |
| Last Update Date | 2017-11-29 |