| NPI | 1972838324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P15975) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: FL 24304) |
| Enumeration Date | 2009-10-02 |
| Last Update Date | 2016-03-10 |