| NPI | 1811447840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MO R1236) |
| Additional Taxonomies | 172M00000X Mechanotherapist (Licence: MO R1236) |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2016-10-13 |