| NPI | 1992102784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2011029429) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IL 070.019827) |
| Enumeration Date | 2014-11-23 |
| Last Update Date | 2014-11-23 |