| NPI | 1790845980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC 870991) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DC PT870991) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2018-12-14 |