| NPI | 1871990051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 21410) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 11161) |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2016-11-13 |