| NPI | 1912109711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 17345) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: DC 3070) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2018-12-07 |