| NPI | 1871969394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 7937) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT30655) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2015-10-13 |