| NPI | 1083136170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OK 6086) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT30840) |
| Enumeration Date | 2017-07-11 |
| Last Update Date | 2021-10-06 |