| NPI | 1043724180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070022424) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IA 099279) |
| 225100000X Physical Therapist (Licence: CA 294973) | |
| 261QP2000X Clinic/Center, Physical Therapy (Licence: OR 62557) | |
| Enumeration Date | 2017-11-28 |
| Last Update Date | 2022-03-25 |