| NPI | 1770031932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 11491) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 3137) |
| 225100000X Physical Therapist (Licence: MA 5503) | |
| 225100000X Physical Therapist (Licence: CA 15135) | |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2016-09-16 |