| NPI | 1063881340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AL PTH8011) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL 30812) |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2023-05-05 |