| NPI | 1710528088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 27704) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT027886) |
| Enumeration Date | 2019-10-08 |
| Last Update Date | 2019-10-09 |