| NPI | 1083396188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: LA CP026844T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: KY 008864) |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2024-01-29 |