| NPI | 1851667984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 18330) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: UT 8134695-2401) |
| 225100000X Physical Therapist (Licence: CO 11526) | |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2012-03-22 |