| NPI | 1972657807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MS PT3116) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: LA PT04355) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2014-05-07 |