| NPI | 1790932713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT PTP-PT-LIC-1549) |
| Additional Taxonomies | 2251N0400X Physical Therapist Neurology (Licence: MT PTP-PT-LIC-1549) |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2020-09-17 |