| NPI | 1053983684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 15459-24) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO PTL.0017781) |
| Enumeration Date | 2021-07-13 |
| Last Update Date | 2024-01-03 |