| NPI | 1992031140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MT 2271) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-2379) |
| Enumeration Date | 2009-10-22 |
| Last Update Date | 2013-07-15 |