| NPI | 1003682717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MO 2023032462) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT41111) |
| Enumeration Date | 2023-12-04 |
| Last Update Date | 2023-12-04 |