| NPI | 1013743046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 29908) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MP R09076) |
| 225100000X Physical Therapist (Licence: NC PT9054) | |
| Enumeration Date | 2024-09-09 |
| Last Update Date | 2024-09-09 |