| NPI | 1063872646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC 16113) |
| Additional Taxonomies | 2251X0800X Physical Therapist Orthopedic |
| 225700000X Massage Therapist (Licence: NC 10308) | |
| Enumeration Date | 2016-02-25 |
| Last Update Date | 2024-08-13 |