| NPI | 1891723144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 26537) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 19105) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2018-08-02 |