| NPI | 1053877316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P18580) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NC P18580) |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2021-08-03 |