| NPI | 1093304651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ LPT33211) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501019856) |
| 225100000X Physical Therapist (Licence: VA 2305214876) | |
| Enumeration Date | 2021-01-18 |
| Last Update Date | 2023-09-15 |