| NPI | 1992894505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 7488) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 10672) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2016-10-25 |