| NPI | 1851602064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 23267) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PA PT022354) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2020-12-16 |