| NPI | 1780005199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 41904) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 60461) |
| 225100000X Physical Therapist (Licence: NY 037221) | |
| 225100000X Physical Therapist (Licence: NJ 40QA01554000) | |
| Enumeration Date | 2014-01-02 |
| Last Update Date | 2019-04-13 |