| NPI | 1083430045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 2305216867) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NY 053479) |
| Enumeration Date | 2024-11-25 |
| Last Update Date | 2024-12-31 |