| NPI | 1942562152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 12075-24) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2016-10-12 |