| NPI | 1013612035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL 42533) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 32813) |
| Enumeration Date | 2023-03-31 |
| Last Update Date | 2024-12-09 |