| NPI | 1992093256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: DC PT871247) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT27381) |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2012-10-11 |