| NPI | 1023654423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA 61285748) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 044893) |
| Enumeration Date | 2019-11-20 |
| Last Update Date | 2022-07-18 |