| NPI | 1891127064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA 00686) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA PT00686) |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2019-08-07 |