| NPI | 1821115288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 26921) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 8630) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2015-08-17 |