| NPI | 1972044956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 8502) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: OR 62147) |
| 225100000X Physical Therapist (Licence: FL 25200) | |
| 225100000X Physical Therapist (Licence: WA 60704654) | |
| Enumeration Date | 2017-03-10 |
| Last Update Date | 2017-03-10 |