| NPI | 1891289062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DE J1-0003903) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NC P18739) |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2019-11-13 |