| NPI | 1902188485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 11630) |
| Additional Taxonomies | 111NR0400X (Licence: MD 11630) |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2022-11-04 |