| NPI | 1891119756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 13615) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 20964) |
| Enumeration Date | 2014-02-13 |
| Last Update Date | 2016-09-08 |